Kim Marie Wallace NP in Family Health PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

KIM MARIE WALLACE NP IN FAMILY HEALTH PLLC

Practice address

20 Dunn CT
Sayville, NY 11782-2002

Phone

(631) 375-4211

Fax

(833) 605-4049

NPI assigned

Mar 29, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Kim Marie Wallace-Schlick, FNP-CNPI 1972032472

Title

FNP

Phone

(631) 375-4211

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kim Marie Wallace-Schlick, FNP-C

  • Family Nurse Practitioner
  • Stony Brook, NY
  • NPI 1972032472
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1711670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711670400000",
    "number": "1336990019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 DUNN CT",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117822002",
            "telephone_number": "631-375-4211",
            "fax_number": "833-605-4049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 DUNN CT",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117822002",
            "telephone_number": "631-375-4211",
            "fax_number": "833-605-4049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIM MARIE WALLACE NP IN FAMILY HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-29",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A",
        "authorized_official_last_name": "WALLACE-SCHLICK",
        "authorized_official_first_name": "KIM MARIE",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "631-375-4211",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brent Thomas Kempf, DPM
• Cort Chedwin Kennedy II, MD
• Brittany Khan
• Princess Sotara Khan, PHARM.D.
• Wendy Lynn Kiel, DDS
• Jennifer Kimpel
• Laurie Kinslow
• KL Counseling LCSW PLLC
• Colleen Ann Klein, NP
• Lisa Marie Knote, MA CCC-SLP

• Family Nurse Practitioner in Sayville, NY
• Providers in Sayville, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.